股骨头坏死后骨盆倾斜角度对人工髋关节置换后功能的影响.pdfVIP

中国中西医结合外科杂志2015年2月第21卷第 1期 股骨头坏死后骨盆倾斜角度对人工 髋关节置换后功能的影响 王史潮，徐仲翔，安漫红 摘要 目的：探讨股骨头坏死骨盆倾斜角度对全髋关节置换术后髋关节功能的影响。方法 ：50例患侧盆下型骨盆倾 斜股骨头坏死患者均行全髋关节置换术，手术前术后行x线检查，测定骨盆倾斜角、髋臼外展角和前倾角，末次随访时评价髋 关节功能。结果 ：骨盆倾斜患者术后髋臼外展角平均为III型(37。)II型(40。)I型(44O7P0．05)，末次随访髋关节功能评分I 型、II型明显高于III型(Po．05)。结论 ：股骨头坏死通常产生患侧盆下型骨盆倾斜，对全髋置换术中髋臼杯外展角有决定作 用，随着倾斜程度加重，术中髋臼外展角应随之减小，骨盆倾斜越重，术后髋关节评分也越低。 关键词 ：股骨头坏死；骨盆倾斜；人工髋关节置换；关节功能 中图分类号：R681．8 文献标识码 ：A 文章编号：1007—6948(2015)01—0026—03 doi：10．3969／j．issn．1007—6948．2015．01．008 EffectofAvascularNecrosisofFemoralHeadafterPelvicInclination on Function afterTotalHipAr- throplasty WANGShi-chao，XUZhong-xiang，ANMan—hong．DepartmentofOrthopaedicsandTraumatolo— gY,WenzhouHospitalofTraditionalChineseMedicine，Wenzhou(325000)，China． Abstract：ObjectiveToinvestigatetheaffectingavascularnecrosisoffemoralheadafterpelvictiltangleon thehipjointfunctionfollowingtotalhipreplacement．Methods Afollow—upanalysison50casesofavascu- larnecrosisofthefemoralheadintotalhiparthroplastypatients，both ipsilateralbasinpelvictilt，ofwhichtype 1 in 18 cases，type IIin 16 cases，and type IIIin 6 caseswasstudied；with preoperativeandpostoperative X—rayexaminations，determinationofpelvicinclinationangle，acetabularabductionandanteversionangle，hip jointfunctionwereassessedatthetimeoflast~llow-up．Results IIIpelvictiltpostoperativeX—raymeasure— mentofacetabularabduction(EVEjoy，37)II(40IEvejoy，)(EVEjoy，44)showedthereweresignificantdif- ferencesbetweenthegroups，butthedifferencebetweentheanteversiongroupswasnotstatistically significant， thelastfollow—up hip function scoreofItype、IItype IIItype，the differencewasstatistically significant． Conclusion Followingavascularnecrosisofthefemoralhead ipsilateralbasinpelvictiltisusuallyproduced， showingadecisiveroleonthetotalhipreplacementacetabularcupabductionangleoftiltwithaggravationofin— traoperativeacetabularabd